J Nurs Care Qual Vol. 28, No. 3, pp. 257–264 Copyright c  2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Implementation of the Josie King Care Journal in a Pediatric Intensive Care Unit A Quality Improvement Project Kathleen Turner, DNP, RN; Karen Frush, MD; R´ emi Hueckel, DNP, CPNP-AC; Michael V. Relf, PhD, RN, ACNS-BC, AACRN, FAAN; Deirdre Thornlow, PhD, RN, CPHQ; Mary T. Champagne, PhD, RN, FAAN The Care Journal is a tool developed by the Josie King Foundation to promote interactive exchange among providers and patients/families. The Care Journal was implemented in a pediatric intensive care unit, and surveys were administered to assess perceptions about use. Parents who used the Care Journal and nursing staff found it to be a useful tool that improved communication, made parents feel more knowledgeable and empowered, and improved parents’ overall perception of the hospital stay. Key words: communication, pediatric intensive care units, patient safety, patient centered care, quality improvement E VIDENCE suggests that patient safety and clinical outcomes can be improved by in- volving patients and families in care. 1-9 To en- gage patients and families in care, meaningful communication between the health care team and patients and families is central to positive safety and quality outcomes. 10-13 Author Affiliations: Duke University School of Nursing (Drs Turner, Hueckel, Relf, Thornlow, and Champagne) and Duke University Health System (Dr Frush), Durham, North Carolina. The authors declare no conflict of interest. K.T. received permission from the Josie King Founda- tion (www.josieking.org) to use the Josie King Founda- tion Care Journal in the project and manuscript. The authors thank the Josie King Foundation, Elizabeth P. Flint, PhD, for editorial suggestions, and Jo Ellen Holt MSN, RN, for graphic assistance. Correspondence: Kathleen Turner, DNP, RN, Box 3322, 307, Trent Dr, Durham, NC 27710 (kathleen. turner@duke.edu). Accepted for Publication: October 1, 2012 Published online before print: October 31, 2012 DOI: 10.1097/NCQ.0b013e318276da87 The use of structured communication strategies, such as including parents in team rounds, and tangible strategies, such as pro- viding printed materials to families, can im- prove family emotional outcomes and reduce treatment intensity and length of stay. 13 Both types of strategies have been documented as successful in the pediatric clinical setting. For example, parents invited to participate actively in team rounds reported that par- ticipation increased their feelings of respect and inclusion and improved their understand- ing of their child’s care. 4,14,15 Use of an In- fant Progress Chart by parents to document their child’s treatment in a neonatal intensive care unit (ICU) improved communication be- tween parents and the health care team by helping families have less decisional conflict, more certainty about the infants’ medical con- ditions, and more shared decision making. 11 Hospitals need tangible interventions that will improve communication between all patients and families and the health care team to improve patient safety and support quality outcomes. 12,16,17 Copyright © 2013 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. 257